Imagine this. There you are in the operating room, standing over a patient mid-surgery. Between the surgeons, assistants, operating nurses and you, it’s a full house. You’re in the process of wrapping up the surgery when somehow amongst the many hands and tiny instruments, a needle, sponge or other medical item gets left behind inside the patient. Years later, the patient returns to the hospital with severe medical complications, only to discover the culprit: a retained surgical item.

尽管医学和手术技术的进步，但保留的手术项目在医学界继续存在问题。阅读，了解项目如何留下，共享社区的成本以及您可以做些什么。

The consequences of retained surgical items

There are roughly4,000 reported annual casesof retained surgical items in the United States, butother studiessuggest the numbers may reach as high as 6,000. Two-thirds of retained surgical items are sponges, but needles, scalpels, clamps, broken pieces of surgical devices and scissors also get left behind, according to theNew York Times。

这些保留手术物品可以在事后结果s medical complications for patients and can even be deadly if not discovered in time. The fatality rate of retained surgical items is 2 percent, according to theNational Center for Biotechnology Information(NCBI).

With medical errors come great financial burdens. In cases of retained surgical items, the average cost per patient is more than $60,000 for hospitalization. And the hospitals pay too – anywhere from $100,000 - $200,000 per malpractice case, according to an investigative report byUSA Today。

What happens when an object is left in the body?

When an item is left in the body after surgery, the body typically responds with local and systematic inflammation. While the patient is already at risk of complications from the surgery itself, the retained surgical item makes them even more vulnerable to infection, adhesions, fistulas and obstructions, amongst other risks.

Patients with retained surgical items most often experience infections and symptoms of pain and tenderness,according to the NCBI。They may go months or even years before identifying the cause of the ailment.

异物如何留下？

Operating rooms are often busy and can sometimes become chaotic. Many professionals contribute to the surgical team and sometimes get switched out over the course of the surgery. Amidst the commotion, misunderstandings on who is responsible for item and sponge counting can occur. Preoccupied, multitasking professionals hurrying under the time crunch of anesthesia can easily make mistakes when counting large amounts of surgical items throughout the surgery.

Surgical items are more likely to be left behind in emergency operations and during unanticipated changes to surgery. Items are also more likely to be left behind in patients with higher body mass index (BMI). However, the more severe issue contributing to retained surgical items is a lack of communication in the operating room, specifically in discussions prior to operation and pertaining to surgical counts,says the NCBI。

Small sponges soaked in blood can be easily overlooked by surgical teams, especially in large cavities like the abdomen,which is where most are left behind。即使在手术队的指定成员在整个手术过程中执行海绵数，它们仍然被忽视。事实上，梅奥诊所的研究发现海绵数目未能提醒手术团队68 percent of the timea sponge was lost.

这对医学界意味着什么？防止保留手术项目的目前的过程不起作用。

What can be done to prevent retained surgical items?

随着在手术的医疗专业人员团队中，您认为跟踪手术项目将是可行和常规的。但是，可能发生计数的混淆和错误。事实上，在患者留下海绵时，四次中的四次，all sponges were deemed accounted for in surgery。

So how can these situations be avoided? Here are a few solutions being explored:

Better technology

One strategy some hospitals have implemented is using tracking technology for surgical devices. Barcoded and radio-frequency detection tools can help surgical teams discover when an item has been left behind before finalizing the procedure. These technologies especially help with hard-to-locate items. The added cost per surgery for the safeguarding technology is around $10, according to an investigative report by今天美国。

教育条例

其他人正在呼吁在外科技术人员的教育，培训和许可中致力于更严格的规定。这些目前是不需要的外科团队的唯一成员certified or meet specific educational standards.Legislature aiming to require new surgical technologists to have graduated from an accredited program and obtain their credentials from theNational Board of Surgical Technology and Surgical Assisting(NBSTSA) is being created to address regulation needs, according to the外科技术人员协会。

It’s up to you…

Retained surgical items are a preventable medical error. As a surgical technician, you can play a crucial role in warding off this avoidable mistake and ultimately protecting the lives of your patients.

Think you’ve got what it takes? Learn more about what it’s like being a surgical technologist and see if you have thesetop skills needed for the job– or check out our手术技术专家学位计划页面to get your training started today!